DorlandHealth

Confronting the Demands of Life in the Face of Traumatic Events

The news shattered the quiet veneer of the morning. In a hotel room on the oneiric grounds of Disneyworld, where she had spent the weekend with her four children, Lee Woodruff did not need to take a step away from the fables and the cartoon heroes for the blind hand of reality to steal its fingers toward her.

It came as a phone call from the president of ABC News. It was grim: her husband had been wounded by a roadside bomb in Iraq. He was alive, but the extent of the damage was unknown. It was serious enough, however, that he was going into emergency surgery in Baghdad as they spoke. Serious enough that there could be no greater guarantee.

The story may sound familiar. At the time in January 2006, her husband, Bob, had been named the co-anchor of ABC’s World News Tonight. After traveling to the Middle East to cover the Palestinian elections, Bob Woodruff had moved on to Iraq to document the progress of the war for special coverage that would coincide with President Bush’s upcoming State of the Union address.

On what was to be his final day of reporting, calamity struck. With a videographer, a soundman and an interpreter, Bob Woodruff was embedded with a military convoy, riding in a tank near Taji, a town to the north of Baghdad. He and the videographer, Doug Vogt, were looking out through a hatch at the top of the tank when an improvised explosive device, or IED, erupted just a few yards from the vehicle. Shrieking through the air, the blast of the large artillery shell caught the two men, exposed to the piercing rocks and debris, in a dangerous, vulnerable position. The reverberations pounded their way across land and ocean, settling through the earpiece of a telephone in central Florida.

“From that moment on, my world, and my children’s world, and of course Bob’s world, was rocked to its foundations,” says Lee Woodruff, who spoke from Los Angeles in mid-May where she was on tour to promote Perfectly Imperfect, her new book that provides a candid look at both the everyday and profound issues that affect her as a wife, a mother, a daughter and in other roles as she approaches 50. “What followed was really a one-and-a-half-year journey to recover for all of us.”

The immediate result, however, was a plane ride back north, followed by a transatlantic flight to Germany, where her husband had been airlifted following his stabilizing surgery in Iraq. The harrowing whirlwind continued: 60 hours in Germany, where her husband remained in a coma, followed by a return to Bethesda Naval Hospital in Maryland. Bob Woodruff had suffered major injuries to his throat, thorax and, what was most concerning, his head. In one of his earliest surgeries, doctors had to remove a portion of his skull to relieve swelling in his brain. He had suffered — in parlance that has emerged in the vernacular as the hallmark injury in the wars in Iraq and Afghanistan — from a traumatic brain injury, or TBI.

Long months of recuperation awaited him. Lee Woodruff, like her husband’s doctors and support team, could not portend the results that would ensue, but the sudden immersion into an unknown and potentially fatal situation subsumed her time, her energy and her spirit. Almost overnight, she had become a constant caregiver.

To make matters more complicated, Lee Woodruff’s parents had relocated to Boston from southern California about a month before her husband’s injury due to her father’s encroaching struggle with dementia at the hands of Alzheimer’s disease. A certified member of the so-called “sandwich generation,” she was tasked with providing care for her aging father and her own growing family. All of these factors made for a thorny position.

“Not only did I have a lot on my plate with my own children, but I had all the worries and concerns and guilt about not being able to be there for my parents when they made this transition,” she says. There is a chapter in Perfectly Imperfect devoted to her coming to grips with her father’s illness and his slow leak of facts and memories. That chapter directly precedes two poignant sections largely devoted to the tribulations of caregiving. Through her experiences over the last few years, Lee Woodruff is something of a sage on the matter. Her insight, though, borne through frantic, worrying times, reveals a technique that brought her a modest degree of peace.

“I would give myself permission to be good at certain things at different periods in time. For example, if I was with Bob in the ICU, I would be a really great wife while I was with him — and know that I was being a really lousy mother. I had to give myself permission to know that there were other wonderful people with my children.”

This narrow focus germinated with the desire to remain strong in a difficult situation. “If I became anxious over the tug-and-pull of what I should be doing, I would only weaken myself,” she says. “As a caregiver, you have to make sure that you’re the strongest person in the room — even though that’s hard to do on a good day.”

The second to last chapter in her new book, published by Random House, is titled “Chutes and Ladders.” A reference to the popular board game, the appellation is a metaphor about the highs and lows one can experience and strive to endure in the arduous role of a caregiver. “You’re up and up and up and you’re holding it all together,” she says, describing the emotional toll inherent in the role. “But at some point that caregiver has to crash. You can’t just keep charging forward without there being some ability and need to turn to yourself and ask, ‘What do I need now?’”

The answer to that question will vary with every person who finds him- or herself engaging in the age-old task of taking care of another in this new — and complicated — modern environment. The staunch support of family, friends and colleagues helped make Lee Woodruff’s hardship bearable. “I couldn’t have survived anything without them,” she says.

But that does not mean she unearthed some type of cosmic key to maintaining an equilibrium over the course of the hardest moments. That, she says, is unattainable. “I think there isn’t any balance in those points in time. And I think you have to surrender to the fact that there’s not balance, and if you try to make balance you’re only going to make yourself crazy,” she says. “That might be a nice idea, but how do I do that in the middle of all this craziness?”

The most helpful anodyne were the gestures and encouragement of those around her. She tells the story of a friend of her husband’s who took a three-hour train ride from New York City to visit him in his early days in the ICU. This man stayed for 20 minutes, she says, and turned around to take the same three-hour ride back. “Those little acts go so incredibly far,” she says. “You feel loved. You feel like you’re part of a greater community.”

The last section in Perfectly Imperfect, titled “What I Know Now,” relates some of the poignant lessons Lee Woodruff has come to appreciate through her experience, which has seen her husband return to work and the continued growth of her children. Courtesy of the author, their keen and humanizing descriptions of what a caregiver needs most — or as she puts it, “things to consider if someone you know or love is facing a life-changing trauma” — are listed here in short form.

DON’T WEAR “THE SYMPATHY FACE.”

When you approach the family or patient with tears in your eyes, it makes them feel as if they have to use precious energy to buck you up. If you can't keep your tears to yourself, come back when you can or write a note.

DON’T ASK REPEATED QUESTIONS THAT MAKE THEM RECOUNT THE WHOLE ORDEAL, THE FACTS AND STATISTICS OR THE ROAD AHEAD.

Take your lead from them when it comes to conversation. I loved it when people just picked up from where we were, not where we'd been. It’s nice to hear news from “the outside world” that has nothing to do with the challenges of the medical situation.

RESIST THE URGE TO SHARE YOUR OWN STORIES ABOUT SIMILAR ILLNESSES OR DISEASES AND OTHER PEOPLE YOU KNOW.

People think that they are saying things that are comforting or hopeful, but they can actually be terrifying or even insulting. These kinds of comparisons, although well-meaning, only serve to magnify or minimize the situation.

DON'T EXPECT THE PATIENT OR CAREGIVER TO GET BACK TO YOU RIGHT AWAY.

All of their energy right now is focused on themselves (if they are the patient) or their loved one and their other immediate family members. The best calls were the ones that started with, “You don’t need to call me back, I just wanted you to know I am thinking of you.”

DON'T BE AFRAID TO ACKNOWLEDGE THE PERSON’S PAIN, IF APPROPRIATE.

It’s OK to say, “This stinks, but I’m here every step of the way.” The most helpful comments you can make involve letting the patient know they are heard.

MAKE DECISIONS ABOUT WHAT THAT PERSON MIGHT NEED WITHOUT INVOLVING THEM.

Asking the patient or caregiver to call you if they need anything puts the burden of asking for help on them. Instead, pick something specific — a ride for the kids or a sleepover, a dinner brought to the house (without dishes that need to be returned), cutting the lawn or walking the dog. Find the people who know them best or are running their household temporarily and make decisions with them on the little stuff as much as possible.

Lastly, I will always remember what someone told me once in the ICU, waiting by Bob’s bedside and I use it to this day:

If you can’t go day by day, live hour by hour.

 

MINDING THE TOLL

Traumatic brain injury has become the signature wound of the wars overseas. They are thought to have affected more than 300,000 service members since 2001. In 2008, Lee and Bob Woodruff founded ReMIND.org, an organization dedicated to raising money and awareness for service members injured in Iraq and Afghanistan and to help them reintegrate upon their return. Their efforts have impacted more than half a million service members thus far. Visit ReMIND.org to learn more.